State regulators stripped Dr. Michael I. Rose's power to write prescriptions two months ago, after health officials found that the pain-clinic doctor had prescribed enough painkillers to put one patient "at risk of death from overdose."
The health department findings are all the more alarming given the North Miami physician's other specialty: drug-addiction treatment.
Rose is one of at least 41 South Florida doctors who straddle the fence between two seemingly opposite disciplines: They treat drug addicts while at the same time giving pain patients addictive drugs that have been blamed for a spike in overdose deaths statewide. Rose declined to comment for this article.
Some of the same clinics offering addiction treatment are often targeted by out-of-state drug couriers seeking painkillers for an illicit black market stretching from South Florida to Appalachia and the northeastern United States.
Many of these doctors who serve as both pain and addiction specialists have been disciplined by state health officials for improper prescribing of drugs -- and some have been convicted of crimes, a Miami Herald review found.
Yet these doctors retain approval from the federal government to prescribe a narcotic called buprenorphine -- a drug used to help wean people addicted to opiates such as oxycodone.
Addiction experts say this mixing of two delicate medical fields has potentially dangerous consequences: Instead of receiving the therapy they need, addicts seeking to get off drugs may simply end up alongside users and drug peddlers who frequently skip from clinic to clinic seeking narcotics to be sold illegally. 'ADDED RISK'
"If you have an environment where you have drug access and availability, then you have an added risk, " said Dr. Ihsan Salloum, an addiction psychiatrist with the University of Miami's Miller School of Medicine.
"Offering services of this kind is a slap in the face, " said Dr. Bernd Wollschlaeger, an addiction specialist and past president of the Dade County Medical Association. He suspects many pain clinics are seeking not to help addicts but to boost profits by selling drugs used to curb dependency -- in addition to selling large amounts of potent painkillers.
"It's just a fig leaf to conceal their true nature, " Wollschlaeger said. "These pain clinics are pure and simple pill mills. Their goals are pushing huge volumes of prescription pills."
Clinics offering both pain medications and addiction treatment can also present difficulties for police investigating pill trafficking. Under federal law, doctors approved to provide addiction drugs are afforded special protection from narcotics investigators. Agents need a court order from a federal judge before pursuing undercover investigations of these doctors.
Over the past two years, South Florida has emerged as the pill-mill capital of the United States, the chief supplier of black-market painkillers that spawned an epidemic of overdose deaths in Kentucky, Ohio, West Virginia, Tennessee and other states.
The pills have flowed by the millions through storefront pain clinics that open up almost daily from Miami to Palm Beach County. Broward County alone has at least 115 pain clinics, and is home to 33 of the 50 doctors who dispense the most oxycodone in the country, according to U.S. Drug Enforcement Administration data.
Dozens of clinics entice patients with blaring advertisements in alternative newspapers, offering coupons and discounts and not-too-subtle appeals to out-of-state clients.
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